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Good health at every size

April 19, 2009 12:35 am

"SIZE IS A SLOPPY and unscientific way to judge someone's health or character" wrote Linda Bacon in her groundbreaking book, "Health at Every Size."

Bacon, who has master's degrees in psychotherapy and exercise science and a doctorate in physiology, based her advice on strong, if controversial, research.

"Let's switch our emphasis to encouraging health-promoting behaviors for all, and let the fat fall where it may," she challenges.

The Health at Every Size movement has been around for years, even before Bacon's new book of the same name was published late last year, and it is gaining strength in mainstream health care. Her book encapsulates many of the movement's key points.

DIETS FAIL

Bacon starts with the premise that diet and exercise don't lead to long-term weight loss.

Sure, many folks lose weight in the short-term when they go on a diet, but most regain that lost weight within five years.

Only up to 5 percent of dieters are successful in the long run, according to data from the National Weight Control Registry and many scientific studies.

Dieting fails, Bacon said, not only because it's hard to do, but because it lowers the metabol-ism so that people burn fewer calories. In dozens of pages, she reviews research showing dieting may raise people's "set point," or natural weight. That may be why many dieters "yo-yo"--each time they lose weight, they regain even more weight.

FITNESS OVER FATNESS

Many scientific studies show that mildly overweight people who are physically fit and eat well actually live longer than underweight couch potatoes.

However, being severely overweight--what doctors call morbid obesity--is associated with health problems and a shorter lifespan.

To be classified as morbidly obese, a 5-foot-4-inch tall woman would have to weigh more than 265 pounds; for a 5-foot-10-inch man, the weight would be 278 pounds.

Bacon writes that much research on weight is flawed. Many studies alleging that being overweight increases the risk of heart attacks, cancer, and diabetes do not take into account fitness and eating patterns, Bacon says.

So, rather than worrying about weight loss, Bacon encourages people to get active and eat well. Her research proves that this approach can improve health.

CHOOSE YOUR STRATEGY

Bacon, a nutrition professor at the City College of San Francisco, and other researchers recruited 78 women between the ages of 35 and 45 for a study; all women were at least a size 16. She divided the women into two groups.

The first group of women did a traditional diet and exercise program--they lost weight, but regained it over time, and their self-esteem plummeted.

About 50 percent of these women dropped out of the program.

The second group of women took classes in Bacon's Health at Every Size program. They focused on enjoying their bodies as is, increasing physical activity, and choosing healthier foods.

Even though they didn't lose weight, these women saw significant drops in blood pressure, LDL or "bad" cholesterol, and depression.

And they were more likely to stick with the program--only 8 percent dropped out compared with 50 percent of the dieters.

GETTING HEALTHY

Instead of counting calories and restricting foods, Bacon urges people to pay attention to their sensations of hunger and fullness.

"Eat delicious food," Bacon writes. "If you're eating only when food appeals to you, then you no longer need to control every bite."

Bacon recommends eating slowly and using a hunger scale or food journal to pay attention to sensations of fullness. She also addresses emotional eating--learn more from her book or Web site.

CHANGE TASTE BUDS

Some people have grown up on fast foods or processed foods. Bacon urges them to enlarge their repertoire of foods, and try to "enjoy a variety of real foods, mostly plants."

Bacon doesn't demand a vegetarian, Twinkie-free diet. But she urges vegetable-haters to experiment and expand their repertoire. For example, people who are sensitive to bitter vegetables such as Brussels sprouts may find they like sweeter vegetables such as carrots, red bell peppers, beets, sweet potatoes, snow peas and green beans.

Squeezing a lemon wedge over vegetables also cuts bitterness and makes them pleasantly tangy.

Bacon also suggests seasoning different ways. For example, try steaming broccoli with a dash of butter and nutmeg, or sauteing broccoli with olive oil and garlic, or roasting broccoli with Parmesan cheese.

THE ROLE OF EXERCISE

As for getting fit, Bacon suggests starting with things that are fun, like taking walks outside, playing Frisbee with a friend or a dog, dancing in the living room and the like.

She encourages building up to longer activities and addresses fears many people have of being ridiculed or unable to keep up.

As a dietitian, I agree with Bacon's approach. Many studies have shown that eating well and exercising can improve blood pressure and cholesterol regardless of weight. Feeling energetic and living longer is more important than size.

Jennifer Motl welcomes reader questions via her Web site, brighteat ing.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.